The African crime novel, an emerging literary genre, is often mirrored on a Western method of writing. The topos of the city, drug-use related crimes, human trafficking and urbanization are ubiquitous in various sub-genres of detective and crime fiction, including political, medical and legal thrillers. In this paper, I critically analyse South African author Chris Karsten's 2012 crime novel The Skin Collector, The Skinner's Revenge (2013) Face-Off (2014) with a specific focus on the use of medical narratives in South African crime novels (and medical thrillers), which has received limited attention from researchers. The following questions are raised and answered: What does medical knowledge add to crime novels? Does it establish some form of equilibrium between rational science and the murderer's irrational mind and behaviour? Can the reader remain "safe' from the novel's reality if perceived rational scientific knowledge forms the counterpart of Lotz's "madness'? While the detective's goal in most crime novels is to explain an event (a murder) that seems inexplicable to the reader at first, Karsten inverses this dynamic by making Lotz—a crazy, irrational individual—the character with the most accurate and highly developed medical knowledge. In this way, the reader remains interested, invested and captured by the narrative until the last page.